The No Flu Here League has begun and there are more than a dozen opportunities on campus to get your flu shots between now and Nov. 14. If you choose exemption, please complete the exemption request form and email to Kelli Fussell in the Medical Staff office along with documentation of medical contraindications by Nov. 1. Exemption requests will be taken to the Medical Executive Committee (MEC) for consideration. If you have received your vaccination elsewhere, please turn in or email your documentation to the medical staff office or employee health by Nov. 14.

The Salem Spine Center is working to develop exemplary professional practice by tapping patients, patient families, physicians and community partners for new knowledge that will help improve patient care every day. Read the full story.

At the August Breakfast with CEO, physicians asked questions regarding ED wait times, the Salem Hospital hospitalist program, the recruitment of a new Chief Medical Officer and the affiliation with OHSU.

We have been using Common Ground as our main means of communication for the past six months and would like to take this opportunity to evaluate how we're doing. Please take a minute to complete a short 5-question survey and let us know your input. We appreciate your feedback as we strive to make Common Ground an effective communications tool for the Salem Health Medical Staff. Take the survey here.

With beautiful new facility upgrades to showcase, as well as expanded programs and offerings, the Salem Cancer Institute hosted an open house for the community on Thursday, Sept. 25. The $4 million project creates a healing and comforting place for cancer patients to receive quality treatment and expertise from health care professionals. Read the full Statesman Journal story.

Effective October 14, the laboratory positive patient identification (PPID) system will go live in the ED with the phlebotomy, RN and respiratory therapy teams.

Salem Hospital is implementing a PPID System for blood draws and eventually all specimen collection. This change brings our hospital practices in line with nationally recognized best practices that ensure patient safety. Salem Hospital's laboratory processes approximately 135,000 specimens annually and our hospital averages 350 Patient Safety Alerts for mislabels annually.
The PPID system uses handheld scanning technology to confirm patient identity and print labels at the bedside.
PPID eliminates rework and improves patient safety. Because the patient's identification bracelet will be scanned when samples are collected, the technology will raise patient satisfaction by reducing patient "sticks" through re-collections.

The hospital's goal is to eliminate labeling errors, which can result in misdiagnosis and inappropriate treatment. The new technology is consistent with the hospital's system for dispensing medication.

The rollout of PPID is occurring in phases with ED and respiratory therapy IP as Phase II. The final rollout will be for all inpatient nursing staff in November. The hospital will train 36 super users for support during this workflow change.

Please be aware of lab system downtime on Oct. 7, from 9 to 10 a.m., to upgrade interfaces for Meaningful Use. During this time, inpatient lab results will move to paper. Orders will continue to flow as usual. Please keep the following information in mind and see MyEpic/Radar for a tip sheet with more information.

Inpatient results will be faxed to the floors.

All critical values will continue to be telephoned to the floors.

All results will be stored in instruments and printed at the completion of the downtime.

Test results for specimens received in the lab and resulted during the downtime will not be viewable in Epic until the lab system is back online.

Inpatient results will be printed inside the lab and cross-checked to ensure all results cross over electronically.

Outpatient results will not be faxed to the ordering provider.

Outpatient critical values will continue to be called to the ordering provider.

Test results for outpatient specimens received in the lab and resulted during downtime will not be viewable in Epic until the lab system is back online.

Outpatient results will be printed and cross-checked to ensure all results cross over electronically.

There will be a command center in place to support this go-live. Please call 503-561-4357 and select 1 for command center.

The Multidisciplinary Peer Review Committee (MPRC) endorses the following recommendations developed by the General Surgery Section in an effort to ensure removal of the correct post-operative drain when multiple drains are present.

1) Patients with more than one drain should have their drains clearly labeled, preferably by the surgeon.
2) If a surgeon asks a nurse to remove a drain in a patient with more than one drain, the surgeon must clearly state and identify in the EPIC order which drain is to be discontinued.

The MPRC and General Surgery Section encourage all services, where relevant, to adopt these recommendations.

Heat will be shut down in the North Tower of Building B between the hours of 6 a.m. and
3 p.m. on Wednesday, Oct. 8. Work will be performed during this time on the heating water lines as part of the 5/6 NW Nursing Unit Renovation. This shutdown does not impact domestic water so there will be no impact to hot water at sinks and for bathing.

Situation: Nuclear Medicine gastric emptying days have changed from Tuesday to Wednesday as of July 1, 2014. All (inpatient and outpatient) gastric emptying exams will now be completed on Wednesdays.

Background: Gastric emptying studies were performed on Tuesdays prior to July 2014. Timeliness for patient care was compromised on this day due to other scheduled exams which had a negative impact on patient satisfaction. Due to this issue gastric emptying day was moved to Wednesdays for all patients.
Assessment: The exam takes about 4.5 hours to complete with multiple scan times throughout that time period, so doing all gastric emptying exams on one day has allowed for the most efficient use of room time for this study while minimizing the impact to other patients. Inpatient studies will be scheduled and completed with the outpatient studies on Wednesdays. If time allows for an inpatient gastric emptying study on other days, the patient will be completed as soon as possible after the order is placed. Each time an inpatient gastric emptying order is placed, the Nuclear Medicine Department will contact the patient's RN to inform them when the exam will be able to be completed.

Recommendation: Order nuclear medicine gastric emptying studies to be done as an outpatient whenever possible. If it is not possible, understand that the Nuclear Medicine Department will do all they can to get the inpatient gastric emptying study completed ASAP, but the study may have to wait until the Wednesday following the order date.

Contact Imaging Services Manager, Justin Millar, at 503-814-1227 or Nuclear Medicine Lead Technologist, Rachel Lacy, at 503-814-9728, if you have any questions.

Liposomal bupivacaine (EXPAREL) was provisionally approved by the Pharmacy and Therapeutics (P & T) Committee for hip or knee replacement in late 2013 on the condition that surgeons would study outcomes associated with the use of the medication to determine if the cost was justified by clinical outcomes. In August, Dr. Dolan returned to P&T with data showing reduced pain scores, reduced use of the femoral nerve block and plans to expedite
discharge of patients who did not receive a femoral nerve block. Based on this information,
P&T gave full approval for orthopedics to continue use of EXPAREL.

Currently, EXPAREL is P&T approved ONLY for use in patients who are undergoing knee or
hip replacement. Providers who wish to use this medication for any other indication are
invited to submit a formulary request and outline a plan that demonstrates use for other
procedures is a cost-effective use of hospital resources.